Upper limb spasticity reduction following active training: A robot-mediated study in patients with chronic hemiparesis

Objective: To compare the effects on spasticity of 2 robotmediated therapies in patients with chronic hemiparesis. Design: Groups comparison. Subjects: Thirty-four patients, divided into 2 homogeneous groups. Methods: Outcome measures were: motor status score, Modified Ashworth scale, and range of motion. A pattern of reaching exercises was implemented, in which the direction and length of the movements were modified with the aim of reducing activity of the flexor muscles and improving extension of the arm. A 3-month follow-up was performed. Results: Statistically significant improvements were found in both groups after treatment. Some differences were found in elbow motor improvement between the 2 groups. Conclusion: Comparison between groups confirms that active movement training does not result in increased hypertonia, but results in spasticity reduction in antagonist muscles by activating the reciprocal inhibition mechanism. Furthermore, robot-mediated therapy contributes to a decrease in motor impairment of the upper limbs in subjects with chronic hemiparesis, resulting in a reduction in shoulder pain.